Perigestational haemorrhage in the exam
Getting a film with perigestational haemorrhage in the exam is one of the many exam set-pieces that can be prepared for.
Transabdominal and transvaginal pelvic ultrasound show an anteverted uterus with an intrauterine gestational sac. MSD is 20 mm in TV study with a single, live embryo (CRL = 5 mm, HR = 140) and a yolk sac consistent with 6 weeks of gestation. There is a 52 mm hypoechoic area adjacent to the sac covers about 50% of sac surface consistent with a perigestational haemorrhage.
The cervix is long and closed. Both ovaries are normal with no adnexal masses or free fluid. I will recommend a follow up scan in 5-7 days to ensure, normal growth and development.
- occurs in 20% of patients with per vaginal bleeding and 3% of all first trimester patients
- a small haemorrhage surrounding <20% of the gestational sac, and a large on surrounds >50% of the sac